Exhibit L - SF1413.pdf
PDF 139 KB Posted
- Attached to
- HEERC Duct Replacement for DHU
- Solicitation number
- ISD-380609-RO
About this file
This is a Standard Form 1413 (Rev. 10/2023), a federal Statement and Acknowledgment form used to document subcontract awards under a prime contract. The form identifies Fermi Forward Discovery Group, LLC, located at Kirk Road and Wilson Street, Batavia, IL 60510, as the prime contractor under prime contract number 89243024CSC000002. The form serves as the official documentation that a subcontract has been awarded, though the specific subcontractor name, subcontract number, date of award, description of work, project details, and location are not completed on this version of the form.
Part II of the form lists the labor standards clauses that are incorporated into the subcontract, including provisions related to the Contract Work Hours and Safety Standards Act, payroll and basic records, withholding of funds, disputes concerning labor standards, construction wage rate requirements, apprentices and trainees, the Copeland Act, subcontracts, contract termination and debarment, and certification of eligibility. The form requires acknowledgment and signature from both the prime contractor and subcontractor representatives, along with identification of any intermediate subcontractors. This form template is authorized for local reproduction and carries an OMB control number 9000-0066 with an expiration date of May 31, 2027.
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Text version
Part I - Statement of Prime Contractor
1. Prime Contract Number
89243024CSC000002
2. Date Subcontract Awarded
3. Subcontract Number
4. Prime Contractor 5. Subcontractor
a. Name Fermi Forward Discovery Group, LLC
a. Name
b. Street Address Kirk Road and Wilson Street
b. Street Address
c. City Batavia
d. State
IL
e. ZIP Code 60510
c. City d. State e. ZIP Code
6. The prime contract does, does not contain the clause entitled "Contract Work Hours and Safety Standards Act -- Overtime Compensation."
7. The prime contractor states that under the contract shown in Item 1, a subcontract was awarded on the date shown in Item 2 to the subcontractor identified in Item 5 by the following firm:
a. Name Of Awarding Firm Fermi Forward Discovery Group, LLC
b. Description Of Work By Subcontractor
8. Project 9. Location
10a. Name Of Person Signing 11. By (Signature) 12. Date Signed
10b. Title Of Person Signing
Part II - Acknowledgment Of Subcontractor
13. The subcontractor acknowledges that the following clauses of the contract shown in Item 1 are included in this subcontract:
Contract Work Hours and Safety Standards Act - Overtime
Compensation (If included in prime contract see Block 6) Payrolls and Basic Records Withholding of Funds Disputes Concerning Labor Standards Compliance with Construction Wage Rate Requirements and Related Regulations
Construction Wage Rate Requirements Apprentices and Trainees Compliance with Copeland Act
Requirements Subcontracts (Labor Standards) Contract Termination - Debarment Certification of Eligibility
Authorized For Local Reproduction Previous Edition Is Not Usable
STANDARD FORM 1413 (REV. 10/2023)
Prescribed by GSA/FAR (48 CFR) 53.222(e)
Statement And Acknowledgment OMB Control Number: 9000-0066 Expiration Date: 5/31/2027
14. Name(s) Of Any Intermediate Subcontractors, If Any
A C
B D
15a. Name Of Person Signing 16. By (Signature) 17. Date Signed
15b. Title Of Person Signing
Paperwork Reduction Act Statement - This information collection meets the requirements of 44 U.S.C. §
3507, as amended by section 2 of the Paperwork Reduction Act of 1995. You do not need to answer these questions unless we display a valid Office of Management and Budget (OMB) control number.
The OMB control number for this collection is 9000-0066. We estimate that it will take .05 hours to read the instructions, gather the facts, and answer the questions. Send only comments relating to our time estimate, including suggestions for reducing this burden, or any other aspects of this collection of information to: U.S. General Services Administration, Regulatory Secretariat Division (M1V1CB), 1800
F Street, NW, Washington, DC 20405.
STANDARD FORM 1413 (REV. 10/2023) BACK
| Part I - Statement of Prime Contractor |
| Part II - Acknowledgment Of Subcontractor |
| STANDARD FORM 1413 (REV. 10/2023) |
File details come from the government source that posted it. Updated .